Back to direct payment: German dentists lobby to leave the national sickness fund scheme

Oral health care in Germany is delivered by private dentists working predominantly in solo practice. Services are financed indirectly by sickness funds for 89 percent of the population. With caries rates declining, dentists' numbers increasing, and federal policies changing the remuneration regulations to enhance preventive behavior in consumers, dentists are concerned about their shrinking incomes. In an attempt to secure their professional interests, a faction among dentists advocates to return to direct payment and to opt out of the sick fund scheme. Their strategy and professional goals are described and the chances of succeeding discussed.